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AMC ethics & medico-legal · Updated 8 June 2026

AMC Ethics & Medico-Legal: AHPRA, VAD, Austroads — IMG Study Guide 2026

Australian medical ethics is statute-driven and state-variable. AMC asks specific questions with specific right answers — Rogers v Whitaker (not Bolam) for consent, AHPRA s140 notifiable conduct, Voluntary Assisted Dying eligibility that differs by state, Austroads driver-fitness intervals, and the Privacy Act 1988 with its 13 Australian Privacy Principles. This page maps every one of them.

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By Mostly Medicine Editorial · Reviewed by clinical-educator IMG team · Updated 8 June 2026

Ethics and medico-legal scenarios are where AMC differentiates candidates who know medicine from candidates who can practise it in Australia. The questions are concrete and the answers are statutory. This page covers the AHPRA registration standards, the consent doctrine, capacity (including Gillick / mature minor), mandatory reporting, confidentiality and duty to warn, Privacy Act 1988, coronial reporting, Voluntary Assisted Dying by state, Austroads Assessing Fitness to Drive 2022, decriminalised termination, and boundary violations.

Sources: Good Medical Practice: A Code of Conduct for Doctors in Australia(Medical Board of Australia, current edition), AHPRA registration standards, theHealth Practitioner Regulation National Law, NHMRC ethical guidelines, the Office of the Australian Information Commissioner (Privacy Act 1988 and APPs), AustroadsAssessing Fitness to Drive 2022, and the relevant state Voluntary Assisted Dying Acts.

AHPRA registration standards

AHPRA and the Medical Board of Australia set the registration standards every doctor must meet for general registration: continuing professional development(50 hours per year minimum, including reviewing performance and measuring outcomes),recency of practice (clinical hours within the last 3 years),professional indemnity insurance, criminal history declaration,English language skills, and the Code of Conduct(Good Medical Practice). For AMC, expect MCQs on each component and OSCE prompts where the candidate must recognise a registration-impacting issue (e.g. a colleague returning after 4 years out of practice triggers recency-of-practice).

Section 140 — notifiable conduct

Under section 140 of the Health Practitioner Regulation National Law, a registered health practitioner has a mandatory duty to notify AHPRAabout another practitioner who has engaged in notifiable conduct. The four categories of notifiable conduct are: (1) practising while intoxicated by alcohol or drugs; (2) engaging in sexual misconduct in connection with practice; (3) placing the public at risk of substantial harm because of an impairment; and (4) placing the public at risk of harm by practising in a way that constitutes a significant departure from accepted professional standards.

A 2020 national-law reform allows treating practitioners to use clinical judgement before notifying about a colleague who is also their patient — but the mandatory floor is still “substantial risk of harm to the public.” AMC traps: don't confuse mandatory professional notifications under s140 with mandatory child protection reporting (different statute, different process), and don't assume your medical defence organisation can waive a mandatory notification — it cannot.

Informed consent — Rogers v Whitaker, not Bolam

Australia abandoned the Bolam standard for informed consent in Rogers v Whitaker (1992) 175 CLR 479. The High Court held that a doctor has a duty to warn a patient of a material risk inherent in a proposed treatment. A risk is material if either: (a) a reasonable person in the patient's position would attach significance to it (the objective limb), or(b) the doctor knows, or ought reasonably to know, that this particular patient would attach significance to it (the subjective limb). The subjective limb is what makes Rogers different — peer practice is not a defence if the patient would have regarded the risk as material.

Practical OSCE: do not present consent as a checklist of percentages. Ask what matters to the patient (occupation, family, hobbies — concert pianist + finger surgery is the textbook example), then disclose risks that engage either limb. Document the conversation, not just the form signature.

Mandatory reporting — child, elder, DV (state-varying)

Child protection reporting is state-legislated. Doctors are mandatory reporters for suspected child physical or sexual abuse in every state and territory; the full scope (neglect, emotional abuse, exposure to family violence) varies. Reports go to the relevant state child protection agency, not police directly. Elder abuse reporting is patchier and largely non-mandatory federally, though aged-care providers have mandatory reportable-incident obligations under the Aged Care Act. Domestic and family violence reporting obligations also vary by state and are generally permissive for adults (mandatory if a child is involved). For AMC, the safe defaults are: any suspected child abuse → mandatory report; document; preserve evidence; safety plan.

Capacity, Gillick competence, mature minor

Decision-making capacity in Australian law is the four-element test (often quoted from Re T [1992] and codified in Australian guardianship Acts): the patient must be able to (1) understand the relevant information; (2) retain it long enough to make a decision; (3) weigh it against alternatives; and (4) communicate the decision. Capacity is decision-specific and time-specific — a patient may have capacity for one decision but not another. Capacity is presumed in adults; the burden is on the clinician to show otherwise.

For minors, Gillick competence (adopted in Australia via Marion's Case (1992) 175 CLR 218) allows a child under 18 to consent to a treatment if they can fully understand its nature, consequences and alternatives. The Australian variant is sometimes called the mature minor doctrine. The clinician assesses this on the specific decision. Note that contraception, mental health treatment and minor procedures are commonly assessed under mature minor; sterilisation and some other “special” categories require court approval regardless of competence.

Substitute decision-makers — VCAT / NCAT

When an adult patient lacks capacity, decisions are made by a hierarchy of substitute decision-makers, defined by state Guardianship and Administration Acts. Order varies but typically: appointed guardian → enduring guardian → spouse/de facto → adult child → parent → sibling → close friend. If none, the public guardian or a tribunal-appointed guardian. Tribunals: VCAT in Victoria, NCAT in NSW,QCAT in Queensland, SACAT in SA, WASATin WA, ACAT in the ACT. For AMC: name the substitute decision-maker process and refer to the relevant state tribunal rather than improvising a clinical override.

Privacy Act 1988 and 13 Australian Privacy Principles

The Privacy Act 1988 (Cth) applies to most healthcare providers and contains 13 Australian Privacy Principles (APPs). The ones you will meet most: APP 1 (open and transparent privacy practices), APP 3 (only collect what you need), APP 6 (use and disclosure for the primary purpose), APP 11 (security of personal information), APP 12 (access on request) and APP 13 (correction on request). Health information is “sensitive information” under the Act and attracts stricter rules. The My Health Records Act 2012 overlays additional requirements for My Health Record access and disclosure.

Confidentiality and duty to warn

Australia does not have a clean equivalent of the US Tarasoff duty to warn. Confidentiality may be overridden where there is a serious and imminent threat to an identifiable person or persons, but the framework is permissive (APP 6.2(c) — permitted disclosure) rather than mandatory. RACGP and AHPRA guidance is to consult your medical defence organisation early; document the threat, the assessment and the disclosure. Mandatory exceptions still apply (child protection, communicable disease notification, gunshot/knife wound in some jurisdictions, court orders).

Coronial reportable deaths

Each state and territory has a Coroners Act that defines reportable deathsthat must be referred to the coroner. The list typically includes: unexpected, unnatural or violent deaths; deaths during or shortly after a medical procedure; deaths of persons in care, custody or care of a person under guardianship; deaths where the cause is unknown; deaths where the deceased had not been seen by a doctor within an appropriate window. If in doubt, report — the coroner's office will guide on whether autopsy is required. Issuing a death certificate that should have been a coroner's case is a notifiable medico-legal error.

Voluntary Assisted Dying — eligibility by state

VAD legislation differs across Australian jurisdictions. As of 2026 all six states have operative laws; the ACT's legislation came into effect in late 2025; the NT's regulatory framework is the most recent. Core eligibility is broadly common across states: adult Australian citizen or permanent resident, resident in the relevant state for the required period, decision-making capacity throughout, an advanced and progressive disease/illness/medical condition expected to cause death within a defined timeframe, and intolerable suffering.

The prognosis window differs by state — Victoria's Act uses 6 months (12 months for neurodegenerative conditions); most other states adopt a12-month prognosis for any qualifying condition. The doctor-initiated discussion rule also differs (Victoria initially prohibited it, was reformed; some states permit it within counselling). For AMC purposes, learn the structure(request, two doctor assessments, capacity throughout, cooling-off period, voluntary at the time of administration) and that specifics differ by state — examiners reward candidates who say “check the relevant state Act” rather than invent a national rule.

Austroads — Assessing Fitness to Drive 2022

Austroads & the National Transport Commission publish Assessing Fitness to Drive: Medical Standards for Licensing and Clinical Management Guidelines (current edition 2022). It is the canonical AU reference for driver fitness — and AMC examines it directly. Common standards you must know:

The doctor's duty: assess, advise the patient, document. Reportingto the licensing authority is mandatory in South Australia and the Northern Territory and permissive elsewhere (where the doctor may report if the patient continues to drive contrary to advice). Always counsel the patient first; document; consider MDO advice.

Decriminalised termination and duty to refer

Termination of pregnancy is now decriminalised in every Australian state and territory, with gestational limits and process requirements varying by jurisdiction. Conscientious objection is recognised — but a doctor who objects has a duty to inform the patient of their right to seek the procedure elsewhere and to refer to a practitioner known not to object. Failure to refer is a recurring AMC ethics scenario. Several states codify the duty to refer explicitly in the relevant Act.

Boundary violations

The Medical Board's Code of Conduct and AHPRA's sexual boundaries guidance are unambiguous: sexual relationships with current patients are professional misconduct, and relationships with former patients are heavily restricted by the nature and duration of the prior therapeutic relationship (psychiatric, GP and long-standing primary-care relationships have the strictest restrictions). Non-sexual boundary issues — gifts, social media contact, dual relationships — are also examined. The safe AMC answer is: decline, document, escalate to a senior, seek MDO advice.

Study with Mostly Medicine

The Mostly Medicine Ethics & Medico-Legal flashcard deck drills s140 categories, Rogers v Whitaker, capacity, Gillick, coronial criteria, VAD eligibility by state, Austroads intervals, Privacy Act and boundary scenarios — spaced-repetition cards mapped to the Medical Board Code of Conduct and the current Austroads edition. Pair it with theCultural Safety deck for the AHPRA 2020 Code update. The full clinical-stations rehearsal lives in theOSCE preparation guide.

Built by IMGs and IT professionals who walked the AMC pathway.

Mostly Medicine is an AMC exam-prep platform — not affiliated with the AMC, AHPRA, the Medical Board of Australia, Austroads, the OAIC, any state Voluntary Assisted Dying authority, or any official body. This page summarises publicly available Australian ethics, statute and regulatory material for educational purposes only — it is not legal advice. Cross-check the current edition of every source before clinical or medico-legal decisions and seek medical-defence-organisation advice.